Jesse M. Boillat, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002734 Issued in CT

Practice address

80 Seymour Street
Hartford Hospital Critical Care Medicine
Hartford, CT 06102-5037

Phone

(860) 545-5200

NPI assigned

Dec 12, 2011

Last updated

Nov 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score

92.63 of 100Reported as group

Quality

75.35

Promoting interoperability

100

Improvement activities

40

Cost

71.44

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hartford Healthcare Medical Group, Inc

  dba Hartford HealthCare Medical Group

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301

  Physician Assistant

  Medicare reassignment NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391
  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1780952242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 415933",
            "address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415933",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL CRITICAL CARE MEDICINE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-545-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOILLAT",
        "first_name": "JESSE",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1100498",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003027349",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lovelyn Natasha Bogle, LCSW
• Odette Bogle, LCSW
• Carl D Bogli
• Brooke Bohn, MD
• R William Bohonnon, APRN
• Cristina Boisvert, DNP, FNP
• Mandi L Boisvert, FNP-C
• Carl J. Boland, M.D.
• Elise M Boland, LCSW
• Boldbravefearless Counseling and Consulting LLC

• Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.